Usuários de drogas injetáveis e infecção pelo Vírus da Imunodeficiência Humana: epidemiologia e perspectivas de intervenção

This paper discusses the user side of harm reduction, focusing to some extent on the early responses to the HIV/AIDS epidemic in each of four sets of localities-New York City, Rotterdam, Buenos Aires, and sites in Central Asia. Using available qualitative and quantitative information, we present a series of vignettes about user activities in four different localities in behalf of reducing drug-related harm. Some of these activities have been micro-social (small group) activities; others have been conducted by formal organizations of users that the users organized at their own initiative. In spite of the limitations of the methodology, the data suggest that users' activities have helped limit HIV spread. These activities are shaped by broader social contexts, such as the extent to which drug scenes are integrated with broader social networks and the way the political and economic systems impinge on drug users' lives. Drug users are active agents in their own individual and collective behalf, and in helping to protect wider communities. Harm reduction activities and research should take note of and draw upon both the micro-social and formal organizations of users. Finally, both researchers and policy makers should help develop ways to enable and support both micro-social and formally organized action by users.

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“…The impact of the AIDS epidemic among IDUs has been observed in other studies in the region (Caiaffa, W.T. & Bastos, F.I., 1998;Osimani, M.L.…”

Section: Buenos Aires Idus' Responses To the Hiv Epidemicsupporting

confidence: 62%

Harm reduction theory: Users’ culture, micro-social indigenous harm reduction, and the self-organization and outside-organizing of users’ groups

Friedman

Jong²,

Rossi³

et al. 2007

International Journal of Drug Policy

190

107

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“…About 21% of all AIDS cases were related to drug use. [5][6][7][8] Harm-reduction approaches, including ready access to sterile injection equipment through syringe-exchange programs (SEPs) and encouraging drug users only to use such equipment, are well supported by evidence as a very important strategy despite some controversies. [9][10][11][12][13] SEPs in Brazil, created since 1995, have provided several different forms of care to the IDUs despite the threatening conditions outreachers encountered due to the national drug legislation and local police activities.…”

Section: Introductionmentioning

confidence: 99%

Estimation of the Number of Injecting Drug Users Attending an Outreach Syringe-Exchange Program and Infection With Human Immunodeficiency Virus (HIV) and Hepatitis C Virus: the AjUDE-Brasil Project

Caiaffa

Mingoti

Proietti³

et al. 2003

Journal of Urban Health: Bulletin of the New York Academy of Medicine

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This study estimated the number of street injecting drug user (IDU) clients of a syringe-exchange program (SEP) who were infected with human immunodeficiency virus (HIV) and hepatitis C virus (HCV). A two-sample capture-recapture method was carried out. The first capture listed all interviewed IDUs outreached for syringe exchange from April 1 to May 1, 1998; the second capture involved those outreached from May 2 to June 6, 1998. Blood spots were collected for HIV and HCV serologies. Analysis used captured probability model varying with time. We interviewed 55 IDUs in the first capture and 99 in the second; 17 participated in both samples. An estimate of 317 IDUs attending the SEP was obtained (95% confidence interval [CI] 235-467). Based on the overall seroprevalence rates for HIV (47.7%) and HCV (53.1%), it was estimated that 151 IDUs were HIV infected (95% CI 112-223) and 168 (95% CI 125-248) were HCV infected. Enumeration of IDUs associated with estimates of the total number of HIV and HCV seropositives provide a powerful tool for SEPs to help monitor the number of IDUs, to plan for provisions, and to organize the new demands on existing health facilities for HIV and HCV care.

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“…Since then, cases of HIV/AIDS related to injection drug use have increased, leading to a greater visibility of this hidden population, which has seldom been targeted by public health interventions [6,7]. The HIV epidemic in Brazil has changed substantially in the past 10 years regarding involvement of IDUs.…”

mentioning

confidence: 99%

The Dynamics of the Human Immunodeficiency Virus Epidemics in the South of Brazil: Increasing Role of Injection Drug Users

Caiaffa¹,

Proietti²,

Proietti

et al. 2003

CLIN INFECT DIS

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Changes in human immunodeficiency virus (HIV) infection among injection drug users (IDUs) are provoking a shift in the pattern of the HIV/AIDS epidemic in some regions of Brazil. IDUs living in 2 cities (Porto Alegre and Itajaí) in southern Brazil were contacted, interviewed, and tested for HIV. In 1998, 187 IDUs were surveyed and, in 2000, 352 IDUs. In Porto Alegre, HIV seroprevalence, age, and duration of injection history increased significantly over time. In contrast, a trend toward decline was observed in Itajaí. Homelessness, joblessness, and prison incarceration, as well as lifetime needle sharing, also increased over time in Porto Alegre. At the time of the study, at both sites, rates of needle sharing and condom use were similar, but use of syringe exchange programs, health and drug treatment, and HIV testing had increased over time. IDUs living in southern Brazil are at increased risk of HIV infection, indicating the continued need for permanent surveillance and preventive strategies.

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Usuários de drogas injetáveis e infecção pelo Vírus da Imunodeficiência Humana: epidemiologia e perspectivas de intervenção

Cited by 10 publications

References 35 publications

Harm reduction theory: Users’ culture, micro-social indigenous harm reduction, and the self-organization and outside-organizing of users’ groups

Harm reduction theory: Users’ culture, micro-social indigenous harm reduction, and the self-organization and outside-organizing of users’ groups

Estimation of the Number of Injecting Drug Users Attending an Outreach Syringe-Exchange Program and Infection With Human Immunodeficiency Virus (HIV) and Hepatitis C Virus: the AjUDE-Brasil Project

The Dynamics of the Human Immunodeficiency Virus Epidemics in the South of Brazil: Increasing Role of Injection Drug Users

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